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Medical Toxicology Review Committee for Emergency Medicine and Preventive Medicine ACGME

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Medical Toxicology Review Committee for Emergency Medicine and Preventive Medicine ACGME Frequently Asked Questions: Medical Toxicology Review Committee for Emergency Medicine and Preventive Medicine ACGME Question Answer Institutions What does the Review Committee consider The Review Committee considers sites that are either within 30 miles or a half-hour as close physical proximity to the primary drive to be within close proximity to the primary clinical site. clinical site? [Program Requirement: I.B.6] If a program wants to establish a rotation at If a program establishes an affiliation with a site that is not in close physical proximity to a site that is not in close physical proximity the primary clinical site due to special resources provided there, the program should to the primary clinical site, what ensure that fellows are provided with adequate transportation to and from the site. If the accommodations should the program site is of such distance that daily travel between the site and the primary site is provide? unfeasible or burdensome, the program may need to provide housing arrangements for fellows while on rotation there. [Program Requirement: I.B.6] If a program has an affiliation with a school No. The purpose of the affiliation with a school of pharmacy or a department of of pharmacy or a department of pharmacology is so that the fellows are provided with regular didactic experience and pharmacology, does it still need to have a consultation by the faculty in the affiliated school or department. If an affiliation with a PharmD or PhD pharmacologist as a non- school of pharmacy or a department of pharmacology is not possible, then alternatively physician faculty member? the program needs to identify and appoint at least one PharmD or PhD pharmacologist non-physician faculty member to provide the required didactics and consultation as [Program Requirements: I.B.7.a) and needed for the fellowship. I.B.7.a).(1)] Program Personnel and Resources What is considered scholarly activity for Faculty scholarly activities include: faculty members? . Peer-reviewed publications in scientific journals with a PubMed reference ID [Program Requirement: II.B.5.d).(1)] . Peer-reviewed publications in scientific journals not indexed in PubMed and that do not have a PubMed ID . Conference presentations – abstracts, posters, and presentations given at international, national, or regional meetings . Other presentations, such as invited professorships Medical Toxicology Updated 04/2017 ©2017 Accreditation Council for Graduate Medical Education (ACGME) Page 1 of 4 Question Answer . Chapters or textbooks . Grant leadership – grants for which the faculty member had a leadership role, such as the PI, Co-PI, or site director . Leadership or peer review role – a leadership role in national medical organizations or service as editor or editorial board member for a peer-reviewed journal . Teaching formal courses – primary responsibility or course coordinator for seminars and/or conference series within the institution or program, including the development of computer-based or other training modules for students, residents, fellows, and other health professionals. This does not include single presentations, such as individual lectures or conferences. These courses can be in topics other than medical toxicology. What is acceptable if a program is unable If a program is unable to secure local consultations from various specialists, it is to secure specialist consultations in botany, acceptable to establish a relationship with non-local resources, as long as they are herpetology, mycology, or zoology locally? accessible and available to the fellows. For example, if a local herpetologist is not available, it would be acceptable to work with one in another state and communicate by [Program Requirement: II.C.2.b)] phone or electronically. Fellow Appointments If a program exercises the “exceptionally When recruiting a new fellow, if a program determines that an applicant has not qualified applicant” eligibility option in completed an ACGME-accredited residency program and does not meet the eligibility recruiting a fellow, and the fellow intends to criteria in Requirement III.A.2., it may exercise the fellow eligibility exception option for seek board certification through the exceptionally qualified applicants. When exercising this option for fellows seeking American Board of Emergency Medicine certification through the ABEM or the ABPM, programs must be aware that completing (ABEM) or the American Board of an ACGME-accredited fellowship program is not by itself sufficient to meet the ABEM Preventive Medicine (ABPM), are there any or ABPM eligibility requirements for subspecialty certification. Programs must contact considerations that should be taken under the ABEM or ABPM directly to determine an applicant’s eligibility for certification. advisement? [Program Requirement: III.A.2.b)] Medical Toxicology Updated 04/2017 ©2017 Accreditation Council for Graduate Medical Education (ACGME) Page 2 of 4 Question Answer What factors will the Review Committee The approval of the total number of fellows in a medical toxicology program will be consider in approving the number of based on the following factors: medical toxicology fellows for a new program application? 1. the number of, qualifications of, and scholarly productivity of faculty members; 2. the volume and variety of the patient population available for educational [Program Requirement: III.B.2] purposes; and, 3. institutional resources available to the program. Educational Program What are some examples of activities to Examples include problem-based learning, laboratory research, computer-based facilitate the planned educational instruction, or joint conferences co-sponsored with other disciplines. experiences? [Program Requirement: IV.A.3.a).(2)] What qualifies a type of resuscitation as A therapeutic approach in resuscitations is one that refers to using medication or other providing a therapeutic approach? medical intervention, and not physical manipulation. [Program Requirement: IV.A.5.b).(3)] Do fellows have to perform analytical and No, fellows do not have to perform these tests. However, they must be able to forensic toxicology tests? competently interpret their results, which may include knowing how the performance of the test may impact the results. [Program Requirement: IV.A.5.b).(8)] What would be considered departmental Administrative responsibilities for fellows could include administrative training that administrative responsibilities for fellows? would lead to opportunities as a medical director of a poison center or toxicology service, and that includes management, quality, and financial aspects. [Program Requirement: IV.A.5.b).(20)] What must be included to ensure a The required educational aspects of a program in the subspecialty of medical program’s curriculum is broad enough to toxicology are delineated in detail in the ABEM’s “The Core Content of Medical cover all of the required aspects of medical Toxicology.” This document can be found on the ABEM website: www.abem.org. toxicology? It is recommended that programs use this document as a guide when developing their [Program Requirements: IV.A.2.b) and curricula. IV.A.6.a)] Medical Toxicology Updated 04/2017 ©2017 Accreditation Council for Graduate Medical Education (ACGME) Page 3 of 4 Question Answer Can fellows count previous critical care Yes. Critical care experiences of at least one month completed in either an adult or experiences toward fulfilling the pediatric ICU setting prior to entering the medical toxicology fellowship may be applied requirement for a medical toxicology towards the medical toxicology program’s critical care requirement. program? [Program Requirement: IV.A.6.d)] What types of patient care experiences At a minimum, and by the end of the program, each fellow must document experiences must fellows document? with: 200 acutely poisoned patients; 25 patients with acute workplace or chronic occupational and environmental toxic exposures; and 240 poisoned patient referral [Program Requirements: encounters. IV.A.5.a).(1).(k).(i); IV.A.5.a).(1).(l).(i); IV.A.5.a.(1).(m).(i); and IV.A.6.k)] The Learning and Working Environment Are there situations in which fellows may The Review Committee will accept licensed or certified individuals to supervise fellows be supervised by licensed independent in unique educational settings within the scope of those individuals’ licensure or practitioners? certification. [Program Requirement: VI.A.2.a).(1)] Examples include physician assistants, nurse practitioners, clinical psychologists, licensed clinical social workers, certified nurse midwives, certified registered nurse anesthetists, and doctors of pharmacy. Indirect oversight by a physician faculty member during these situations is required. What does the Review Committee consider Each program must adhere to its graduated responsibility policy. This may vary by area an optimal clinical workload? of service, based upon each individual fellow’s level of achieved competence (knowledge, skills, and attitudes), and based upon patient acuity. The Milestones must [Program Requirement: VI.E.1.] be used to assess each fellow’s competencies. Both insufficient patient experiences and excessive patient loads may jeopardize the quality of fellow education. Medical Toxicology Updated 04/2017 ©2017 Accreditation Council for Graduate Medical Education (ACGME) Page 4 of 4 .
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